In recent years, an increasing number of healthcare providers have initiated outpatient or home healthcare programs for their patients. The potential benefits of these home healthcare programs are particularly great for chronically ill patients who must treat their diseases on a daily basis. However, the success of these programs is currently limited by the ability of healthcare providers to monitor the patients remotely to avert medical problems before they become complicated and costly. Unfortunately, no convenient and cost effective monitoring system exists for the patients who have the greatest need for monitoring, the poor and the elderly.
Prior attempts to solve the problem of remotely monitoring patients have included the use of personal computers and modems to establish communication between patients and healthcare providers. However, computers are too expensive to give away and the patients who already own computers are only a small fraction of the total population. Further, patients who own computers are typically young, well educated, and have good healthcare coverage. Thus, these patients do not have the greatest unmet medical needs. The patients who have the greatest unmet medical needs are the poor and elderly who do not own computers or who are unfamiliar with their use.
Similar attempts to establish communication between patients and healthcare providers have included the use of the internet and internet terminals. Although internet terminals are somewhat less costly than personal computers, they are still not sufficiently inexpensive to give away to patients. Moreover, monthly on-line access charges are prohibitive for poor patients.
Prior attempts to solve the problem of remotely monitoring patients have also included the use of interactive telephone or video response systems. Such interactive systems are disclosed in U.S. Pat. Nos. 5,390,238 issued to Kirk et al. on Feb. 14, 1995, 5,434,611 issued to Tamura on Jul. 18, 1995, and 5,441,047 issued to David et al. on Aug. 15, 1995. A disadvantage of these systems is that they either require a patient to call in to a central facility to be monitored or require the central facility to call the patient according to a rigid monitoring schedule.
If the patients are required to call the central facility, only the compliant patients will actually call regularly to be monitored. However, it is the non-compliant patients who have the greatest need for monitoring to avert medical problems before they become complicated and costly. If the central facility calls each patient according to a monitoring schedule, it is intrusive to the patient's life and resistance to the monitoring grows over time. Further, it is difficult to identify each patient uniquely using these conventional interactive response systems. Additionally, these systems are generally incapable of transmitting medical data collected in monitoring devices, such as blood glucose meters or peak flow meters.
It is also known to use monitoring devices with modems to monitor patients remotely. Unfortunately, these monitoring devices do not allow flexible and dynamic querying of patients for other information, such as quality of life measures or psycho-social variables of illness.